Q: What is Measure 101?

Measure 101 would impose a 0.7 percent tax on large hospitals and a 1.5 percent tax on many health insurance policies. The taxes would raise $210 million to $320 million in the current two-year budget.

Q: Why does Oregon need more health care money?

Oregon is one of the states that expanded its Medicaid program under the Affordable Care Act in 2014, to allow people earning up to 138 percent of the federal poverty level to qualify. That's currently $33,948 for a family of four. Previously, Medicaid was generally only for people living at no more than 100 percent of the poverty line.

A lot of people qualified under the new guidelines, and our state added 375,000 people to Medicaid.

At first, the federal government covered the entire cost. But states were supposed to gradually pitch in more and more, and Oregon has to come up with its share. That raised the state's yearly cost about $136 million.

The federal government also asked Oregon to pay more for other people on Medicaid this budget cycle, because our economy has been doing well.

Finally, state lawmakers expanded Oregon's Medicaid program last year to cover unauthorized immigrant children starting Jan. 1.  That is projected to cost $27 million a year.

Oregon hospitals: Please tax us to relieve ER demand, net nearly $1 billion from feds

Q: Will Oregon's Medicaid program go away if voters say "no" to Measure 101?

No. The state will still have money to cover most of the 1 million people on Medicaid in Oregon.

But more than 300,000 people could lose coverage, depending upon how lawmakers would respond.

If voters reject Measure 101, it could create a $210 million to $320 million hole in the state's Medicaid budget. Lawmakers would have a variety of options to rebalance the budget when they meet in February. They could make cuts in other areas, reduce the services covered by Medicaid or kick people off the health insurance program. Lawmakers could also adopt some combination of those strategies.

Even if the Legislature relied only on cuts to balance the budget, it's unclear how many people might lose Medicaid. That's because of the large range in costs for the state to cover different groups of people. For example, the federal government pays most of the cost to cover adults who were added under the Affordable Care Act expansion. In contrast, the state pays 100 percent of the cost to cover unauthorized immigrant children.

15 percent of residents could lose health coverage in one Oregon county. See other counties' rates.

The state must maintain Medicaid coverage for certain people, including those with disabilities who are unable to work. According to the Oregon Health Authority, the state can legally cut coverage for at least three groups: adults with higher incomes added since 2014, kids on the Children's Health Insurance Program and uninsured women who access breast and cervical cancer treatment through Medicaid.

Q: Is there a backup plan if voters turn down Measure 101?

Yes. However, it has not been publicly vetted. Two Republican lawmakers who oppose Measure 101, Rep. Julie Parrish of West Linn and Rep. Cedric Hayden of Roseburg, announced on Tuesday they filed an alternative funding bill for the short legislative session in February. It would expand an existing hospital tax to other health care providers such as surgical centers and ambulance companies, and potentially raise money from a "tobacco tax." The actual bill has not been released publicly.

Supporters of Measure 101 have not publicly detailed a backup plan.

If voters reject Measure 101, there will likely be a legal fight over what that means. The three Republican lawmakers who successfully put referendum on taxes before voters wanted to completely overturn both taxes. However, a lawyer for the Legislature issued an opinion last year that Measure 101 would delay, rather than completely kill, the hospital tax.

Q: Why do state officials want to tax health insurance?

Mostly, it's another way for the state to pay for the Medicaid expansion. But approximately $31 million of the insurance taxes would fund Oregon's new reinsurance program, according to a state budget document. It's supposed to make the cost of individual insurance premiums from different insurance companies lower, by reimbursing the insurers for particularly expensive medical claims.

Oregon already launched the reinsurance program, and the state says individual insurance premiums this year were 6 percent lower as a result. The state also noted insurers have already passed along the cost of the 1.5 percent tax to consumers, as allowed under a 2017 law.

-- Hillary Borrud

503-294-4034; @hborrud